1976, 04-02 Permit App: L3203 Residence0
County of Spokane, Washington
BUILDING CODES DEPARTMENT, N. 811 JEFFERSON, SPOKANE, WASHINGTON 99201
APPLICATION FOR LAND USE OR STRUCTURE PERMIT
GENERAL REQUIREMENTS PERMIT FEE
PERMIT REQUIRED. A land use or structure permit is required by County Resolution to erect a building or structure of any I
kind or alter any building or structure already erected, or to change a land use. Construction mast conform with the
Spokane County Building Code and Zoning Ordinance. Construction is subject to inspection.
WATER. Water supply must be approved by the County and State Health Departments. Where work on water connections disturbs'
the surface, shoulders or ditches of County Roads, permission must be obtained from the County Engineer's Office.
SEWAGE SYSTEM. Permits are required in all cases by County Resolutions Nos, 45-133 and 47.235.
SET -BACK FROM PROPERTY LINES. In most zones and under most circumstances, a set -back from the front property line, of at
least 25' is required, a 5' side yard, 15' side yard from a flanking street, and a 25' rear yard are required.
STATE HIGHWAYS. Where the structure abuts a State Highway, clearance must be obtained pertaining to set -back and ingress
and egress.
COUNTY ROADS. Work on street right-of-way may not be performed until staked by County Road Department and work must be
performed in accordance with stakes. Points of ingress and egress must be approved by the County Engineer.
MOVING OF BUILDINGS. A permit is required to move an existing building. When a building is moved on a County
Highway, clearance must be obtained from the County Engineer and/or State Highway Department.
ACCESSORY BUILDINGS. Accessory buildings (garages, sheds, etc.) require a separate permit.
RESTRICTIVE COVENANTS. Builders should check provisions of covenants or dedications and easements running with the land
which are enforceable through civil action. County Officials can not bring action to enforce covenants or dedications.
APPLICANT FILL IN BELOW THIS LINE '
C% lT,• Address ao 7Ro, 972OT1Phone t28-7aa.l
ej��a i.cC 4'-t F�
J
3
or State
Name of Owner f'.
Architect (/ Address Phone
Engineer Address Phone
Contractor Address ,,,. zi Phone—/V-iert A -a
Legal Description of Property (Give complete description from deed, tax receipt, etc.) ..% 76i-5/3 - // 0 /
Lo-* 1 ,32Q q min L1�a•r �* �
•
DESCRIPTION OF WORK:pNew_ ' Addition
Size of Lot O F3 6 2( 1 5S
sats earerr
Remodel
` u
Stories/A- _Dimensions 4,4a % .1 i ze,
Rooms I� Baths ) Basement Foundation Const
(Full, part, none
Moving
Sewage System
Total Sq
tat o
Heat. System,C0cer- X.4 Type of Roofing etI !re) ' Ext Finish
Use of Bldg.
Bldg. Zone —/ Fire Zone
Ct." , Cat Const. Foe
00 (Fr., Conc., Br., etc.)
Ft /rip Vijtuation S.$j 9
`` Chimne Kind) / Fireplace /
(4--'041,0/ ;JWaII Finish �.0 yUj74/1
Olaa-c,w//Use,e ` u�eiu.r f2Ler_ No of Units 2 Bedrooms r�
PLOT PLAN
Draw sketch with dimensions showing: (1) property lines; (2) street or road locations; (3) location of existing and
proposed buildings; (4) distance to property lines and streets; (5) dimensions of buildings; (6) location of sewage sys-
eo) and water supply lines. t7
NORTH
SOUTH
N
H
State License No.
+Ind. Ins. Acct. No.
REQUIRED
Plumbing Permi
Heating Perm. ,22
Sewage Permit es.nsst4rcg
B
Plans Received
Plans Checked
Plans Returned
Plans Picked Up
Plans Mailed
t
I hereby certify information submitted is correct and there are no other structures located on this property except
as shown.
• /Owner or Agent Date
A LAND USE OR STRUCTURE PERMIT MUST BE ON THE PREMISES BEFORE CONSTRUCTION COMMENCES.
THIS 1S NOT A PERMIT.
0» a a
DO NOT WRITE BELOW THIS LINE
Your street address will be , L %a i4 ' The zone is ../2."."1,..
Sewage Permit Number Issued Building Permi 3s 0.2 Receipt Delaysued
Remarks
Form 523 Bldg. Code
•I
PLOT PLAN: Land and Building Dimensions, Location of buildings, driveway, etc. on lot.
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